Delayed and Overlooked Diagnosis of an Unusual Opportunistic Infection in a Renal Transplant Recipient: Visceral Leishmaniasis
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Case Report
P: 183-185
December 2010

Delayed and Overlooked Diagnosis of an Unusual Opportunistic Infection in a Renal Transplant Recipient: Visceral Leishmaniasis

Turkiye Parazitol Derg 2010;34(4):183-185
1. Department of Nephrology, Adana Training and Research Center, Başkent University, Adana
2. Department of Infectious Diseases and Clinical Microbiology, Adana Training and Research Center, Başkent University, Adana
3. Department of Microbiology and Clinical Microbiology, Adana Training and Research Center, Başkent University, Adana
4. Department of Hematology, Adana Training and Research Center, Başkent University, Adana, Turkey
No information available.
No information available
Received Date: 29.09.2010
Accepted Date: 24.12.2010
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ABSTRACT

Visceral leishmaniasis is a rare opportunistic infection in renal transplantation patients and its presentation may be associated with or masked by many other factors in immunosuppressed patients. So, if it is not searched for in particular, diagnosis may be easily overlooked or delayed in renal transplant patients. A 32-year-old renal transplant recipient devoleped splenomegaly, pyrexia and pancytopenia. Six months after the fi rst bone marrow examination, the delayed diagnosis was made possible by a second bone marrow aspiration. Liposomal amphotericin B was effective in his treatment although he had a recurrence. Early diagnosis of visceral leishmaniasis is crucial for the renal transplant recipient’s therapy; and even in treated patients, the mortality rate may be high. In our case, although the time up to diagnosis was as long as six months after the onset of symptoms, response to treatment was satisfactory with higher doses of liposomal amphotericin B in the second cycle. Also, in the short term, the rate of recurrence was comparable to other reported patients who were diagnosed and treated in a month.

Keywords:
Renal transplantation, visceral leishmaniasis, pancytopenia, fever, hepatosplenomegaly